ELENA QUINN
Dependent on policy B04M000268
Claims
2
Attributed to this person
Charged
571.00
Total submitted
Denied
296.33
2 denied claims
Patient responsibility
0.00
Reported on the 835
Patient responsibility is the amount reported on the 835 as assigned to the patient — deductible, coinsurance or copay. It is not proof that the provider billed the member, that the member owes it, or that it was collected, and it is kept separate from denied amounts throughout.
Who this is
| Field | Value |
|---|---|
| Name | ELENA QUINN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000268 |
| Date of birth | 17 Apr 2006 |
| Plan | PLATINUM PPO |
| Covered from | 30 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001158 | 25 Oct 2025 | 81.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 81.00 |
| CLM0001159 | 3 Oct 2024 | 490.00 | MERIDIAN HEALTH PLAN | CARC 109 · COB | 215.33 |